Between 1980 and 1986, 14 of our patients had traumatic globe ruptures three days to 13 years after penetrating keratoplasty. There were eight men and six women, ranging in age from 29 to 82 years (average, 62 years). All ruptures occurred at the corneal donor-host interface. Eleven wound separations occurred with corneal sutures in place. Three of five patients who wore protective eyewear at the time of injury had final visual acuity of 20/200 or less. Final visual acuity was better than 20/200 in only seven patients. The force of the blunt trauma was the most significant factor in visual outcome. Ultimate causes of visual failure included posterior segment damage and intractable glaucoma.